Button and continuous loop for fixation of ligaments

Abstract

A technique and reconstruction system for ligament repair employing a continuous loop/button construct. The button has an oblong configuration and is provided with at least one inside eyelet that allows the passage of the continuous loop, preferably a suture loop. The continuous loop/button construct of the present invention may be used for fixation of bone to bone, or of soft tissue to bone.

What is claimed as new and desired to be protected by Letters Patent of the United States is: 
     
       1. A method of positioning tissue within the body, comprising the steps of:
 providing a suture loop/button construct having a continuous suture loop and a button attached to the continuous suture loop, the button having a body and two eyelets extending through opposing surfaces of the body, the continuous suture loop being attached to the button by passage of the continuous loop through the two eyelets, and a single passing suture, wherein the single passing suture is passed through only one of the two eyelets; 
 providing the suture loop/button construct in the vicinity of tissue to be positioned; 
 attaching the tissue to be positioned to the continuous suture loop of the suture loop/button construct by folding the tissue to be positioned over the continuous suture loop; 
 inserting and passing the suture loop/button construct with the attached tissue to be positioned, and pulling the suture loop/button construct with the attached tissue to be positioned through a socket or a tunnel in a bone, using only the single passing suture passed through only one of the two eyelets, the button having a length of about 10 mm to about 20 mm and a width that is about 1 mm narrower than a width of the socket or the tunnel through which the button is inserted and passed through, the passing suture single passing the folded tissue to be positioned into the socket or the tunnel in the bone, the button exiting the socket or the tunnel and beginning to flip horizontally as it exits cortical bone; and 
 facilitating complete deployment of the button by distal traction on the folded tissue to be positioned and release of the single passing suture such that the button is secured on an outside surface of the bone and thereby secures the attached tissue to be positioned within the socket or tunnel. 
 
     
     
       2. The method of  claim 1 , wherein the tissue to be positioned is biological or non-biological tissue. 
     
     
       3. The method of  claim 1 , wherein the tissue to be positioned is selected from the group consisting of a ligament, tendon, bone and cartilage. 
     
     
       4. The method of  claim 1 , wherein the tissue to be positioned is a soft tissue graft or a BTB graft. 
     
     
       5. The method of  claim 1 , wherein the continuous suture loop comprises a first portion formed of a single suture strand and a second portion formed of a plurality of suture strands. 
     
     
       6. A method of conducting arthroscopic surgery, comprising the steps of:
 forming a bone tunnel or socket; 
 providing a suture loop/button construct in the vicinity of the bone tunnel or socket, the suture loop/button construct comprising a button having two eyelets, a continuous suture loop attached to the button by passage of the continuous loop through the two eyelets, the continuous suture loop comprising a first portion formed of a single suture strand and a second portion which furcates from the single suture strand to a plurality of single suture strands, and a passing suture passed through one of the two eyelets; 
 attaching a graft to the continuous suture loop of the suture loop/button construct by folding the graft in half over the continuous suture loop; 
 subsequently inserting the graft attached to the suture loop/button construct into the bone tunnel or socket and passing the suture loop/button construct through the bone tunnel or socket by pulling the suture loop/button construct with the attached graft using only the passing suture passed through only one of the two eyelets, the passing suture passing the folded graft into the bone tunnel or socket, the button beginning to flip horizontally as it exits cortical bone; and 
 facilitating complete deployment of the button by distal traction on the folded graft and release of the passing suture such that the button is secured on an outside surface of the bone, thereby securing the graft within the bone tunnel or socket. 
 
     
     
       7. The method of  claim 6 , wherein the graft is a soft tissue graft or a BTB graft. 
     
     
       8. The method of  claim 6 , wherein the bone tunnel or socket is a femoral or tibial bone tunnel or socket. 
     
     
       9. The method of  claim 6 , wherein the suture loop is formed of a suture material comprising ultrahigh molecular weight polyethylene. 
     
     
       10. The method of  claim 6 , wherein the button has an oblong configuration. 
     
     
       11. The method of  claim 6 , wherein the button has a length of 10 to 20 mm. 
     
     
       12. The method of  claim 6 , wherein the button has a width that is less than 1 mm narrower than a width of the bone tunnel or socket. 
     
     
       13. The method of  claim 6 , wherein the bone tunnel or socket is formed in a retrograde manner using a rotary drill cutter. 
     
     
       14. The method of  claim 13 , wherein the rotary drill cutter comprises two opposed sides provided with cutting surfaces on both sides. 
     
     
       15. The method of  claim 14 , wherein the rotary drill cutter is configured for cutting in two opposite directions. 
     
     
       16. A method of knee ligament reconstruction, comprising the steps of:
 forming a first socket in femur by conducting a retrograde drilling using a rotary drill cutter; 
 forming a second socket in tibia by conducting a second action using the rotary drill cutter; 
 providing a suture loop/button construct in the vicinity of the first and second sockets, the suture loop/button construct comprising a button with two eyelets, a continuous suture loop attached to the button by passage of the continuous loop through the two eyelets, and a passing suture passed through only one of the two eyelets, wherein the continuous suture loop comprises a first portion formed of a single suture strand and a second portion which furcates from the single suture strand to a plurality of suture strands; 
 attaching a graft to the suture loop of the suture loop/button construct by folding the graft in half over the suture loop; 
 pulling the suture loop/button construct with the attached graft through the first socket using only the passing suture passed through one of the two eyelets, the passing suture passed through only one of the two eyelets, the button beginning to flip horizontally as it exits cortical bone abutting the first socket; 
 facilitating complete deployment of the button by distal traction on the folded graft and release of the passing suture such that the button is secured on an outside surface of the cortical bone abutting the first socket and thereby secures the attached graft within the first socket; and 
 securing the graft within the second socket.